Receding Gums

West Los Angeles Receding Gums

Receding Gums...

Why do gum tissues tend to recede? There are those who reach their 60’s and 70’s without showing much recession; while others begin showing recession in their twenties! Believe it or not, stress is a big contributor to gingival recession.

​Stress often leads to clenching and grinding. This causes the teeth to flex and bend more than they are biologically meant to, resulting in tiny pieces of tooth structure breaking away around the gum-line. This chipping away leads to concave blemishes on the neck of the tooth right at the gum-line, which interferes with the biological attachment of the gums to the tooth, which in turn causes to gums to recede away from the damaged area on the tooth.

Receding Gum Line...

Vigorous brushing and flossing also cause gum recession. Our Hygienists will teach you the proper brushing and flossing techniques. We suspect that there may well be a stress component to the reasons behind patients brushing and flossing with too much aggression.

Poor nutrition and hormone deficiencies are also implicated in many gum recession cases. It’s important that we all eat as healthy as we can as often as we can. Sugar plays a huge negative role in the health of our teeth and gums! Most people understand that sugar turns to acid on our teeth and begins to dissolve the minerals from our tooth structure within 20 minutes of sugar coming into contact with the teeth. Decay is simply acid de-mineralizing tooth structure…. It’s that simple. But how does sugar affect our gum tissue? ​The following is a gross oversimplification of a complex biological process: When sugar is ingested into our bodies, it enters the blood stream and causes scratches in the lining of our blood vessels. These scratches must be repaired; so cholesterol rushes to the scratch and covers the injured vessel lining. With excessive sugar consumption, the cholesterol builds up as a substance called plaque. Over time this plaque builds up to the point where it obstructs normal blood flow. This leads to high blood pressure and diminished blood flow to the capillaries which are the tiny vessels that deliver nutrition to each individual cell in the body. The gum tissue is one of the first places where diminished blood flow becomes evident. The gums become easily inflamed because there is not enough nutrition and oxygen being delivered. That’s why many Diabetic patients tend to loose teeth, and toes and feet. Sugar is HUGELY implicated in the body’s breakdown. Yes this is an oversimplification; but you get the picture!!

Receding Gums Treatment...

There are several methods for treating receding gums. The severity of the case at the time of treatment plays a major role in the methods used.

We currently provide a relatively new approach to covering the roots of teeth where recession has occurred. This newer technique is called Pinhole Surgical Technique (PST).

​This PST technique has less pain and trauma involved, usually we don’t even need sutures, post-operative pain is greatly reduced, the cosmetic result and stability of the re-positioned tissue is more reliable, and the healing time is faster with less pain!

Pinhole Surgical Technique...

Simply put, we loosen the attachment of the gums with special instruments which access the gum attachment through small pinholes. We don’t separate the part of the gum that fills the space between the teeth; but we loosen the papilla between the teeth in such a manner that allows us to slide the entire gum tissue down over the exposed root of the tooth where recession has occurred.

We don’t need large incisions and we don’t need to remove tissue from the palate since we slide collagen fibers through the pinholes, and with special instruments, place the collagenous membrane between the gum and bone at the point where we want the tissue to re-attach to the root surface.

Special preparation treatments have already been performed on the exposed root surface which increase the likelihood that the gum tissue will stay in place and reattach at this more desirable position. The collagen fibers hold the tissue in its new position, and allow the gums to re-establish connection to the root surface. When the tissue is completely healed the resulting gum tissue is stronger and less prone to recede again.

Pinhole Gum Surgery Cost...

The total cost will depend on the severity and the extent of your condition, and will be determined once we have seen you in person.

Typically $1,500 per quadrant is what you can expect when you are a good candidate for the procedure:

This means that for someone who needs the Pinhole Surgical Technique for their entire mouth, the total cost would be $6,000 (usually done in separate appointments, for example treat the upper arch first, then about 6 months later treat the lower arch).

If you only need the Pinhole Surgical Technique for half of your mouth (entire upper arch for example), the total cost would be $3,000 (usually done in just one visit).

And if you only need the Pinhole Surgical Technique for one quadrant only (upper left quadrant for example), the total cost would be $1,500​For patients with PPO dental insurance, the Pinhole Surgical Technique is usually covered under your plan, and typically it will pay out your yearly maximum towards it. We will obtain a breakdown of benefits, and a pre-authorization, so that you know ahead of time what your total patient responsibility will be for the procedure.

Gum Graft Surgery...

Some years ago, Dr. Carlston performed a type of intervention which required the removal of a strip of gum tissue from the roof of the mouth of the patient. This technique is called the Free Connective Tissue Graft (FCTG). This worm like piece of tissue was then grafted to the gum tissue that was suffering recession in an attempt to add more tissue to the area and use a type of tissue that is more durable than the thin fragile tissue that often exists after the gum tissue has receded significantly.

To be sure, Dr. Carlston experienced some success with this technique; however the patient often suffered pain that was frankly beyond the benefit of the surgery since the gum tissue often receded back close to the pre-surgery location on the tooth. Much of the time the only benefit Dr. Carlston could see was the remaining grafted gum tissue was stronger, and less prone to continued recession; but the cosmetic effect Dr. Carlston and the patient desired simply did not materialize. This was a very frustrating time because the need to intervene in the loss of gum tissue attachment was very real; but the anticipated results were simply not obtained in many cases.

Our experience with the Pinhole Surgical Technique (PST) is that it is more predictable than the Free Connective Tissue Grant (FCTG) technique described above. We find the cosmetic result is better; and over time the gum tissue has less recurrent recession issues.

Gum Surgery Cost...

The cost of the older Free Connective Tissue Graft technique is the same as the newer Pinhole Surgical Technique, and therefore since there is not even a financial benefit for the patient we do not use this technique in our office. We exclusively use the Pinhole Surgical Technique, at the cost mentioned above.